肋骨内固定联合机械通气对创伤性连枷胸合并肺挫伤患者呼吸功能及呼吸系统并发症的影响  

Effect of Rib Internal Fixation Combined with Mechanical Ventilation on the Respiratory Function and Respiratory Complications of Patients with Traumatic Flail Chest Combined with Pulmonary Contusion

作　　者：陈颖[1] 李先华 钱涵泓 CHEN Ying;LI Xianhua;QIAN Hanhong(Department of Thoracic Surgery,Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine,Wuxi,Jiangsu Province,214000 China)

机构地区：[1]南京中医药大学附属无锡医院胸外科,江苏无锡214000

出　　处：《世界复合医学》2021年第9期133-136,共4页World Journal of Complex Medicine

摘　　要：目的探讨肋骨内固定联合机械通气对创伤性连枷胸合并肺挫伤患者呼吸功能及呼吸系统并发症的影响。方法选取2014年7月—2020年9月在该院接受治疗的创伤性连枷胸合并肺挫伤患者60例,依据治疗方案将患者分为研究组(n=45)及对照组(n=15)。研究组患者采用肋骨内固定及机械通气治疗,对照组采用胸带外固定联合机械通气治疗,比较两组治疗前后血气分析指标、呼吸系统并发症。结果研究组患者机械通气及ICU治疗时间、总住院时间均相对于对照组缩短,差异有统计学意义(P<0.01)。从入院时至治疗后3 d两组患者PaO_(2)、SaO_(2)逐步升高,差异有统计学意义(P<0.01),研究组患者术后PaCO_(2)较前逐步降低,差异有统计学意义(P<0.01);手术治疗后1 d、3 d PaO_(2)、SaO_(2)均明显高于对照组,差异有统计学意义(P<0.01),治疗后3 d PaCO_(2)低于对照组,差异有统计学意义(P<0.01)。治疗后研究组呼吸系统相关并发症发生率15.6%低于对照组53.3%,差异有统计学意义(χ^(2)=6.667,P<0.05)。结论肋骨内固定联合机械通气可显著改善创伤性连枷胸合并肺挫伤患者呼吸功能,降低呼吸系统并发症,且缩短患者住院时间,安全可靠。Objective To investigate the effect of rib internal fixation combined with mechanical ventilation on the respiratory function and respiratory complications of patients with traumatic flailing chest combined with pulmonary contusion.Methods From July 2014 to September 2020,60 patients with traumatic flail chest combined with pulmonary contusion who were treated in the hospital from July 2014 to September 2020 were selected.According to the treatment plan,the patients were divided into a study group(n=45)and a control group(n=15).Patients in the study group were treated with internal rib fixation and mechanical ventilation,and the control group was treated with external chest band fixation combined with mechanical ventilation.The blood gas analysis indexes and respiratory complications of the two groups were compared before and after treatment.Results The mechanical ventilation,ICU treatment time and total hospital stay of patients in the study group were shorter than those in the control group,the difference was statistically significant(P<0.01).From admission to 3 days after treatment,PaO_(2) and SaO_(2) in the two group increased gradually,the difference was statistically significant(P<0.01),and the PaCO_(2) in the study group gradually decreased after surgery,the difference was statistically significant(P<0.01);PaO_(2),SaO_(2) at 1 d,3 d after surgery were significantly higher than the control group,the difference was statistically significant(P<0.01),and the PaCO_(2)3 d after treatment was lower than the control group,the difference was statistically significant(P<0.01).After treatment,the incidence of respiratory system-related complications in the study group was 15.6%lower than that in the control group,and the difference was statistically significant(χ^(2)=6.667,P<0.05).Conclusion Rib internal fixation combined with mechanical ventilation can significantly improve the respiratory function of patients with traumatic flail chest combined with pulmonary contusion,reduce respiratory complications,and shorten

关 键 词：创伤性连枷胸 肺挫伤 肋骨内固定 机械通气 呼吸功能 并发症 

分 类 号：R65[医药卫生—外科学]